Provider Demographics
NPI:1699068783
Name:EASTERN SHORE CARE SERVICES
Entity type:Organization
Organization Name:EASTERN SHORE CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:STAGGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-929-7850
Mailing Address - Street 1:2935 THOUSAND OAKS DR STE 294
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-3563
Mailing Address - Country:US
Mailing Address - Phone:210-494-1100
Mailing Address - Fax:251-929-2500
Practice Address - Street 1:411 N SECTION ST
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-2649
Practice Address - Country:US
Practice Address - Phone:251-928-9090
Practice Address - Fax:251-990-0520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-23
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical